EMTALA Update

EMTALA E-BULLETIN #29
From Steven Frew's medlaw.com
Frew Consulting Group, Ltd.

We have been provided a briefing document that HHS Secretary Tommy Thompson shared with medical leaders recently on the administration's plans for revision of CMS. The document basically parallels the prior letter from Rep. Pete Stark on EMTALA, and aims at the scope of EMTALA triggering events.

Proposals:
"HCFA should reexamine how EMTALA applies to individuals presenting to non-emergency care sites on the hospital's main campus, reviewing the role of non-medical staff."

and

"The expansion of EMTALA to non-hospital property beyond the main campus should be revised to a standard of close proximity. Moreover, emergency personnel would not be expected to leave the premises unless an emergency situation was observed or brought to their attention."

COMMENT:
This is pretty much what I predicted. In comments to the proposal, it appears that there will be an effort made to roll back EMTALA from hospitals that do not have a formal emergency department. Should that occur, that will effectively exempt most private psychiatric hospitals, many California hospitals, and some in other regions that have closed ED's. This may look reasonable initially, but I predict it will have two very negative effects -- the first is that it will ENCOURAGE hospitals to close Emergency Departments just to avoid EMTALA; and second, that it will allow those hospitals that have abandoned the emergency care needs of their communities to dump on their neighbors legally.

Call me cynical...but that's my prediction.

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